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Report 48: Mental health, employment and the social care workforce

Introduction

Employment rates vary greatly according to the type of impairment a person has; only 20 per cent of people with mental health problems are in employment (2)

This guide addresses two main research questions about mental health and employment:-

What is the evidence about discriminatory practice, at recruitment as well as during employment, against people with mental health problems?

What is the evidence about recruitment and retention practices that can enable these groups of people to secure and retain employment in the social care workforce?

Government policy states a firm intention to make it possible for working age adults to gain and retain competitive employment that utilises their skills and knowledge, regardless of mental health problems DWP DH (1) and the cross-Government Health, Work and Well-being programme of work is overseeing a range of initiatives to support this policy (see Law, policy and guidance).

This guide sets out the main findings from narrative and intervention studies, reviews, guidance and policy that have been systematically identified. Its purpose is to inform the policy, practice and research agendas on mental health, employment in the context of the social care workforce.

It sets out some conclusions and recommendations drawn from this research to inform staff in occupational health, human resources and line managers in the social care field of what helps retain employees with mental health problems and enable people with mental health problems to succeed in gaining or regaining employment in social care.

Some facts about mental health and employmentOpen

The adult and children’s social care workforce consists of almost two million, mainly female employees (3), (4)

Among the working age population, nearly one in six people will be experiencing mental health problems such depression or anxiety at any time. If drug or alcohol dependence are included, this frequency increases to one in five (5) (6)

Far fewer people have more severe mental health problems. Approximately one per cent of the working age population has a diagnosis such as schizophrenia, bipolar disorder or severe depression (7).

Best estimates are that between 10 and 20 per cent of people with severe mental health problems are in paid employment (6).

Mental health problems including stress could account for up to five per cent in staff turnover. (6)

The total cost of mental ill health in England in 2009 - 10 is estimated as £105.2 billion – including an estimated £53.6 billion representing the negative impact on life quality. Of this total, almost 30 per cent - £30.3 billion - was in lost economic output, and £21.3 billion was spent on health and social care (13).

The average employee takes seven days off sick a year, of which 40 per cent are for mental health problems (6)

Estimates of economic costs per annum from absenteeism (people being off work from mental health problems) are £8.4 billion, while presenteeism (lack of productivity due to mental health problems) is estimated at £15.1 billion (8). Presenteeism is difficult to measure and can include people who are less productive than usual following a managed phase or reduced work pattern

Some research challenges traditional systems of measuring absenteeism, suggesting they are do not take into account ‘extensionism’ - the fact that in flexible modern work situations (as opposed to those where employees clock on and off), many workers extend their hours to make up time lost, in order to achieve their work goals (9).

Structure of this reportOpen

This report summarises evidence and provides links to further information relevant to those working in social care who have responsibility for the mental health and wellbeing of employees in their organisations (i.e. line managers and people working in occupational health and human resources). It contains the following sections:

The importance of mental health in employment

What keeps people with mental health problems from working in social care?

Law, policy and guidance related to mental health and employment

The social care workplace and mental health

What helps people with mental health problems gain and regain employment?

Who helps people with mental health problems gain and regain employment?